Acute Pulmonary Decompensation Due to Amphotericin B in the Absence of Granulocyte Transfusions

To the Editor: Amphotericin B is often used empirically in the treatment of patients who are granulocytopenic after chemotherapy and have fever that is unresponsive to broad-spectrum antibacterial agents.¹ Pulmonary toxicity, manifested as acute dyspnea, mild hemoptysis, new infiltrates on chest films, and intraalveolar hemorrhage identified by lung biopsy, has been described in granulocytopenic patients receiving both amphotericin B and leukocyte transfusions.² Some authors dispute this association.^3,4 We describe a case of acute pulmonary decompensation in a granulocytopenic patient receiving amphotericin B and blood products other than granulocytes. A 51-year-old woman with undifferentiated myeloid leukemia had a fever shortly after…